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About EINet
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Vol. V, No. 12~ EINet News Briefs ~ June 28, 2002
The EINet listserv was created to foster discussion, networking, and collaboration in the area of emerging infectious diseases (EID's) among academicians, scientists, and policy makers in the Asia–Pacific region. We strongly encourage you to share their perspectives and experiences, as your participation directly contributes to the richness of the "electronic discussions" that occur. To respond to the listserv, use the reply function. In this edition: 1. OVERVIEW OF INFECTIOUS–DISEASE INFORMATION
AMERICA US (New York) – E. Coli
As of 21 June 2002, health officials have identified a total of 26 cases of E. coli in two towns in Rockland County, NY that are 10 miles apart. Two cases occurred in Orangetown, also known as Orangeburg, and 24 cases in Monsey. Although the outbreaks occurred at approximately the same time, they are thought to be unrelated. Tests have shown that the Orangetown girls and the Monsey children are infected with different strains of E. coli O157:H7. On 14 June 2002 health officials in Orangetown confirmed
E. coli O157:H7 contamination of ground beef found in the family freezer
of a six–year–old girl who is seriously ill with E. coli O157 infection.
The family purchased the contaminated meat on 12 May 2002 at a wholesale
food store in West Nyack. On 7 Jun 2002, the state Department of Agriculture
and Markets tested four meat samples chosen at random from the distributor,
but all samples tested negative for E. coli O157 bacteria. For this
reason investigators believe that the meat may have been contaminated
after it left the store. The second Orangetown case is thought to have
contracted E. coli O157 infection from the first case. The sources of
the two outbreaks remain unknown. US (New Mexico) – Chronic Wasting Disease Currently, there is no known relationship between CWD
and other humans or animals diseases, such as the other transmissible
spongiform encephalopathies (TSE) variant Creutzfeldt–Jakob disease
(vCJD) and Bovine Spongiform Encephalopathy (BSE). However, state officials
are encouraging hunters to follow precautions when handling dead game
and advising hunters not to consume any neural tissue.
ASIA
Philippines (Iloilo Province) – Dengue Fever Thailand (Bangkok and Khon Kaen) – Hand, Foot and Mouth
Disease According to the U.S. Centers for Disease Control and Prevention (CDC), HFMD begins with a mild fever, poor appetite, malaise, and often a sore throat. One to two days after fever begins sores that start as small red spots and then blister develop in the mouth. A skin rash, usually located on the palms of the hands and soles of the feet, develops over one to two days with flat or raised red spots. Symptoms usually disappear without medical treatment after approximately seven to 10 days. The incubation period for the disease is three to seven days. The disease is usually found in children aged five years and younger, with 20 to 30 cases reported each year in Thailand. Infection, which can be fatal, is spread through contact with nasal discharges, saliva, feces, fluid from blisters, and items used by an infected individual. The child–care center has been inspected by the Health
Department and deemed clean and hygienic. It is thought that the children
may have contracted the virus from urine and waste. Officials have concluded
that the virus causing this outbreak of HFMD is different from that
which occurred in Singapore, when 200 schools were closed. The source
of the outbreak has yet to be identified. Hong Kong – Hand, Foot & Mouth Disease RELATED NEWS Republic of Congo – Ebola Hemorrhagic Fever Ecuador (Quito) – Foot and Mouth Disease
Quarantine
US (Florida) – Hepatitis A Outbreak
Health officials in Central Florida, United States have confirmed a second death in Polk County from hepatitis A. A 36–year–old Auburndale man died from the disease on 5 June 2002. The cause of death was attributed to hepatitis A with complications from chronic hepatitis C infection. In the first five months of 2002, the Polk County Health Department has confirmed 185 cases of hepatitis A. However, more recently, officials have been documenting approximately four to seven new cases a week. Officials are investigating the source of the virus, focusing
on methamphetamine users and their contacts because injection drug users
are identified as a high–risk group. Health officials are not certain
how the Auburndale man contracted the disease, although tainted restaurant
food has been ruled out. In April of 2002, six cases were linked to
one restaurant, a Bartow landmark called John's Restaurant and Lounge.
They contracted the disease in Jan 2002 after eating food handled by
an infected cook and one died in March of 2002. At present the restaurant
is declared safe. Investigations are continuing. [Editor comment: It
is recommended that all persons with chronic hepatitis C infection get
the hepatitis A vaccination (not immune globulin) to try and prevent
this very serious complication of co–infection.] Republic of Korea – Foot and Mouth Disease Asia–Pacific Facing Wider HIV/AIDS Epidemic
According to a new study the UN Economic and Social Commission for Asia and the Pacific (ESCAP), HIV/AIDS is rapidly reaching epidemic levels in parts of Asia and the Pacific. Until recently, only Cambodia, Myanmar and Thailand had documented significant nationwide epidemics. According to an UNWire report, there are seven million people living with HIV/AIDS in the region, where 60 percent of the world’s population resides. According to ESCAP, the number of people living with HIV/AIDS in the region may reach monumental proportions if the current rate of new infections persists. Countries in South Asia and East Asia are suffering the most dramatic increases in rates. [UNWire http://www.unfoundation.org/unwire/util/display_stories.asp?objid=26183, 6/05/02] Foot and Mouth Disease Vaccination Policy A preventive vaccination has previously been used in Europe.
The program aided in reduction of the numbers of outbreaks from hundreds
of thousands in the 1960s to a couple of thousand in the 1980s and 1990s.
However, the policy was abandoned in 1991 for trade reasons. Early Detection of Variant Creutzfeldt–Jakob Disease Researchers led by Dr. Robert G. Will, of the National CJD Surveillance Unit in Edinburgh, Scotland have described the early psychiatric and neurological characteristics of those with variant Creutzfeldt–Jakob disease (vCJD) using medical records of the first 100 people diagnosed with the disease in the United Kingdom. Currently, the only method for definitively diagnosing vCJD, a disease which is hard to detect early in disease progression, is through a brain autopsy. vCJD is believed to be transmitted through beef and other bovine products from cows infected with bovine spongiform encephalopathy (BSE). The study, which appears in the 22 June 2002 issue of the
British Medical Journal, found that the majority of those in early stages
of disease had psychiatric symptoms, but that psychiatric symptoms follow
neurological symptoms in 15 percent of cases. In the early stage of disease,
patients commonly suffered withdrawal, anxiety, depression and insomnia
and were often seen by a psychiatrist. There were no common neurological
symptoms early on; however, in the early stage of disease progression
some patients experienced persistent pain in their limbs, trunk or face.
The authors also found that both types of symptoms are present in combination
for 22 percent of cases from the onset of disease. The combinations of
characteristics described in the study may help diagnose vCJD and recognition
of symptoms in early disease progression may aid in detecting outbreaks
of vCJD sooner. Variation in Response to Typhoid Fever Infection As part of their research the authors characterized a Salmonella
typhimurium mutant that was known to establish persistent infection in
certain mice. They did not expect to find that a single base pair change
could produce such a substantial effect on the bacteria's pathogenesis.
The mutation in the Salmonella genome that infects typhoid carriers disables
a “house–keeping” enzyme that usually degrades genetic material
to prevent a build–up in the bacterial cell. The results of this paper
aid in understanding the distinction between acute and persistent infection
through new findings related to the bacteria.
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